The overall objective of the present Program Project proposal is to improve our understanding of the pathophysiologic mechanisms leading to hypoxic-ischemic brain damage in the human fetus and newborn infant and to develop effective strategies to prevent or minimize permanent brain damage which ultimately leads to mental retardation or developmental disability. Our specific aims include: 1) to elucidate underlying cellular and molecular mechanisms responsible for the occurrence of hypoxic-ischemic brain damage in perinatal animals; 2) to investigate mechanisms of hypoxic-ischemic neuroprotection through preconditioning and metabolic and pharmacologic manipulations; 3) to ascertain the contribution of oxidative stress and inflammatory mediators to the production of perinatal hypoxic-ischemic brain damage; 4) to study the effects of perinatal hypoxic-ischemic brain damage on short- and long-term cerebral development; and 5) to investigate the role of status epilepticus in perinatal hypoxic-ischemic brain damage. Included in the Program Project Proposals are 7 basic research projects and 3 Core projects, the latter to include an Administrative and Biostatistics Core, Neuropathology Core, and MR spectroscopy and imaging Core. The individual research project titles are: 1) Oxidative Metabolism; 2) Energy Metabolism; 3) Neuroprotective Mechanisms; 4) Inflammatory Mediators; 5) Oxidative Stress/Glia; 6 Cellular Differentiation; and 7) Status Epilepticus. Scientific disciplines represented in the Program Project include pediatric neurology, perinatology, neuroscience, neuropathology, neuroradiology, computer science and biostatistics. It is anticipated that the findings derived from the described research endeavors will have direct relevance to preventative and therapeutic interventions necessary to reduce substantially the significance and severity of mental retardation and developmental disability in developing human infants and children.